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AMNIOGRAPHY FOR DETECTION OF CONGENITAL MALFORMATIONS

From the Department of Obstetrics and Gynecology. The New York Hospital-Cornell Medical Center, New York, NY.

The association of hydramnios with congenital malformations is helpful because it alerts the clinician to the problem. Diabetes, erythroblastosis fetalis, and multiple gestation are conditions that initially should be ruled out. In a 20-year review of 86,301 consecutive deliveries, one-third of all patients with unexplained hydramnios had fetuses with congenital malformations. Although the roentgenogram detects skeletal abnormalities, amniography is necessary to diagnose such soft-tissue malformations as encephalocele, meningomyelocele, or exstrophy of the bladder. In addition malformations involving the gastrointestinal tract can be detected. Prenatal diagnosis of congenital malfaormations is important in order to avoid intrapartum maternal and fetal trauma as well as to provide surgical correction immediately postpartum.